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General NPI Number Information
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NPI Number | 1275289423
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Entity Type | Individual
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Provider Name | ALBERTA-JANE LAWRENCE
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Gender | Female
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Dates
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Enumeration Date | 02/25/2022
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 1050 NE HOSTMARK ST STE 201
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City | POULSBO
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State | WA
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Zip | 98370-7538
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Country | US
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Telephone | 360-990-7330
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1140
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City | SUQUAMISH
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State | WA
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Zip | 98392-1140
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Country | US
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Telephone | 360-990-7330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SC60344715
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License Number State | WA
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